Global Mental Health Reforms: Mental Health Care in Anglophone West Africa

2014 ◽  
Vol 65 (9) ◽  
pp. 1084-1087 ◽  
Author(s):  
Oluyomi Esan ◽  
Jibril Abdumalik ◽  
Julian Eaton ◽  
Lola Kola ◽  
Woye Fadahunsi ◽  
...  
2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Richard Mpango ◽  
Jasmine Kalha ◽  
Donat Shamba ◽  
Mary Ramesh ◽  
Fileuka Ngakongwa ◽  
...  

Abstract Background A recent editorial urged those working in global mental health to “change the conversation” on coronavirus disease (Covid-19) by putting more focus on the needs of people with severe mental health conditions. UPSIDES (Using Peer Support In Developing Empowering mental health Services) is a six-country consortium carrying out implementation research on peer support for people with severe mental health conditions in high- (Germany, Israel), lower middle- (India) and low-income (Tanzania, Uganda) settings. This commentary briefly outlines some of the key challenges faced by UPSIDES sites in low- and middle-income countries as a result of Covid-19, sharing early lessons that may also apply to other services seeking to address the needs of people with severe mental health conditions in similar contexts. Challenges and lessons learned The key take-away from experiences in India, Tanzania and Uganda is that inequalities in terms of access to mobile technologies, as well as to secure employment and benefits, put peer support workers in particularly vulnerable situations precisely when they and their peers are also at their most isolated. Establishing more resilient peer support services requires attention to the already precarious situation of people with severe mental health conditions in low-resource settings, even before a crisis like Covid-19 occurs. While it is essential to maintain contact with peer support workers and peers to whatever extent is possible remotely, alternatives to face-to-face delivery of psychosocial interventions are not always straightforward to implement and can make it more difficult to observe individuals’ reactions, talk about emotional issues and offer appropriate support. Conclusions In environments where mental health care was already heavily medicalized and mostly limited to medications issued by psychiatric institutions, Covid-19 threatens burgeoning efforts to pursue a more holistic and person-centered model of care for people with severe mental health conditions. As countries emerge from lockdown, those working in global mental health will need to redouble their efforts not only to make up for lost time and help individuals cope with the added stressors of Covid-19 in their communities, but also to regain lost ground in mental health care reform and in broader conversations about mental health in low-resource settings.


2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Yvonne Larrier ◽  
Monica D. Allen ◽  
Irwin M.H. Larrier

Global mental health research is continuing to unearth the multiple systemic barriers that over 80% of the world’s population experiences in their search for cultural, contextual, and efficient mental health treatment and services. The widespread gaps and shortages in treatment, research, interventions, financial resources, and mental health care specialists are enduring and expansive thus leaving behind many communities and societies in low and middle income countries and high income countries. Whereas there are numerous approaches to these gaps, this article proposes a re-conceptualized approach to the promotion, practice, and intervention of mental health services locally and globally, with the Cultivating SEEDS System (CSS™) framework. This framework addresses two of the most prevalent barriers – the stigma associated with accessing mental health care resources, and the lack of mental health care professionals.


2019 ◽  
Vol 57 (1) ◽  
pp. 19-31 ◽  
Author(s):  
Frederick W. Hickling

The contentious debate on evidence-based Global Mental Health care is challenged by the primary mental health program of Jamaica. Political independence in 1962 ushered in the postcolonial Jamaican Government and the deinstitutionalization of the country’s only mental hospital along with a plethora of mental health public policy innovations. The training locally of mental health professionals catalyzed institutional change. The mental health challenge for descendants of African people enslaved in Jamaica is to reverse the psychological impact of 500 years of European racism and colonial oppression and create a blueprint for the decolonization of GMH. The core innovations were the gradual downsizing and dismantling of the colonial mental hospital and the establishment of a novel community mental health initiative. The successful management of acute psychosis in open medical wards of general hospitals and a Diversion at the Point of Arrest Programme (DAPA) resulted in the reduction of stigma and the assimilation of mental health care into medicine in Jamaica. Successful decentralization has led to unmasking underlying social psychopathology and the subsequent development of primary prevention therapeutic programs based on psychohistoriographic cultural therapy and the Dream-A-World Cultural Therapy interventions. The Jamaican experience suggests that diversity in GMH must be approached not simply as a demographic fact but with postcolonial strategies that counter the historical legacy of structural violence.


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